Owned and operated by staff with over 90 years of insurance experience specializing in wet marine, Seacoast has been a Program Administrator representing only American insurance companies rated Excellent for decades. We strive to forge long-lasting and productive relationships with our appointed Brokers by combining high quality coverage and one-on-one designated customer service with the ability to handcraft policies for specific risks at the “right” price.

TRAILER INFORMATION

ADDITIONAL INTERESTS

Please List All Persons And/Or Organizations As They Wish To Be Listed On Your Policy As Additional Named Insureds:

Name:

Address:

COVERAGE

H&M Limit:*

H&M Deductible:

P&I Limit:*

P&I Deductible:

Skiff/Tender Limit:

Skiff/Tender Deductible:

Trailer Limit:

Trailer Deductible:

BOW Limit:

BOW Deductible:

Other Limit:

Other Deductible:

Passengers For Hire?*

Yes

No

If Yes, How Many*:

*If more than 6 passengers (or 12 passengers if over 100 gross tons), please provide a copy of the USCG Certificate of Inspection

Do You Wish to Provide Coverage for your Crewmembers?*

Yes

No

Number of Crew Members

Full Time Hard

Part Time Hard

Full Time Soft

Part Time Soft

OR, Crew Schedule (Number & Dates):

POLLUTION COVERAGE

Would You Like a Pollution Quote?

Yes

No, already placed elsewhere

No (Assured understands that as a result of not purchasing pollution coverage, through Seacoast or another entity, that wreck removal coverage provided under the primary hull and P&I policy may be deleted.)

TOWING OPERATIONS ONLY

Does This Vessel Perform Salvage Work?

Yes

No

If Yes, Coverage for Salvage is Available for Additional Premium. Do you want a quote for Salvage Coverage?

Yes

No

PREVIOUS INSURANCE INFORMATION

Previous Insurance Company:*

Policy Expiration Date:

Previous Premium:

ADDITIONAL INFORMATION

Target Premium:

Attachments - Additional documentation that can be provided now in order to round out the submission is greatly encouraged. This, ultimately, allows for the fastest most accurate pricing, terms & conditions. If available and applicable please attach items such as the following: Survey, USCG COI, Skipper's Questionnaire(s), Captain's License(s), Etc.